It Really Is The Same Old Story We Have Seen Many Times Before I Believe!

It really is amazing how many of these stories I have read over the years. Why do they recur?

Bendigo Health staff survey reveals safety concerns over electronic patient records

ABC Central Victoria / By Anna Chisholm

29-11-2023

"Massive safety risk", "threat to patient safety", and "moral distress" are phrases used by unidentified Bendigo Health workers responding to an "experience survey" about the service's Electronic Patient Record (ePR) system.

Key points:

• The ABC has obtained a copy of a report on the results of a staff "experience survey" understood to have been shared internally
• The report includes unidentified Bendigo Health workers' comments, with some staff sharing concerns about patient safety
• It found more than 50 per cent of clinicians surveyed had plans to leave Bendigo in the next two years

The ABC has obtained a copy of the survey report prepared by KLAS research, which was shared with some staff internally last Thursday. 

It included comments from staff that the system was putting patients at risk and exhausting workers.

According to the document, more than 50 per cent of clinicians reported plans to leave Bendigo in the next two years with nurses and allied health professionals reporting high levels of burnout.

"The ePR, as it stands now, is a threat to patient safety, which is increasing mortality and morbidity in this hospital," a consultant staff specialist commented.

Bendigo Health's website states the ePR was introduced in late November 2020.

"Using an ePR improves patient safety, improves medication safety, and allows decisions to be made about your care with up-to-date information available to care teams," the service stated on its website.

'Death from a thousand cuts' 

The comments from staff included in the report repeatedly referenced stress and exhaustion.

"Since the introduction of this system during the first wave of COVID-19, my work stress, mental fatigue, and general displeasure of coming to work and having to troubleshoot this system every time have significantly increased," one nurse stated.

A consultant staff specialist commented: "The difficulty accessing information in an efficient manner for even minor things feels like death from a thousand cuts."

"There are potential risks imposed by the incomplete or difficult-to-access information, but the difficulty getting solutions makes me give up trying to do anything about it," they wrote.

"This causes moral distress on a near daily basis."

The report was circulated internally and includes a number of comments from staff.(Supplied)

A staff member in nursing and midwifery said: "I have reduced my hours at Bendigo Health and am seriously considering my future here."

"I used to believe I was a good nurse and provided excellent care to my patients, but I no longer feel that way," they said.

'Just don't click it'

The report stated using the system to record medications was a repeated concern for doctors and nurses.

"The drug chart is significantly difficult to read and interpret, often misleading the nursing staff to actual dosages prescribed, leading to many and multiple drug errors that have significantly affected patients," a survey response from a nurse read.

"Nurses have access to change the dosage and medications prescribed, which isn't safe, but we have been told, 'just don't click it'," the nurse continued.

"I can't think how this system passes national regulations since nurses could change prescriptions on a whim or with a mis-click."

Another nurse said they were in a group that tested the system initially and brought up concerns around its "usability".

They said "on many occasions" staff in the surgical services department "cannot see medications given in other departments, let alone give medications chartered by doctors".

Another nurse commented the ePR was complicated for doctors to prescribe medications, and "increases the likelihood of drug errors".

"We spend a lot of time interrupting [doctors] to amend orders," they said.

'Not easy to use, learn or maintain'

A worker in nursing and midwifery said in their survey response the system was difficult to "orient new staff to, particularly if they are also new to the ICU environment".

"In some respects, the program is a barrier to safe documentation," they said.

A consultant commented: "It is not easy to use, learn, or to maintain, and it does nothing to enhance the clinical experience."

"This is especially detrimental for our rotational doctors who are only with us for a short period of time and have little motivation to learn the system," they said.

The report also noted a number of responses in the section for other comments or concerns "mentioned patient safety issues", which it said was "atypical". 

"This underscores the need for reliable functionality, excellent training, and strong communication, and shared ownership," it continued.

Some positive responses

A consultant staff specialist — who also described the system as a threat to patient safety — said they "feel like a guinea pig being constantly and systematically bullied and harassed by a computer".

"We should move back to a paper-based system and then move to one of the programs which are proven to actually work," they said. 

An allied health worker commented: "The ePR seems to be an alternative system that does not provide improved efficiency or safety when compared to paper."

The report also included positive comments from staff members. 

"As someone who is tech savvy, it has helped me greatly with efficiency," an allied health professional commented.

A nurse said integrated information was "helpful and they do improve patient safety and care outcomes". 

A registrar or fellow also noted that "overall it is a pretty good system once you are familiar with it".

Staff concerns taken 'very seriously'

In the following statement, a spokesperson for Bendigo Health said it was taking concerns about the ePR system "very seriously".

"The survey was proactively initiated by Bendigo Health's leadership team to ensure staff had an opportunity to speak up and provide feedback as part of our commitment to continuous improvement for our ePR program.

"The ePR program involves a combination of hardware and software components and like any major digital transformation initiative it entails significant change management. Our core clinical system is purpose built and successfully deployed across Australia and 26 other countries.

"We would like to reassure our staff and our community that upon receipt of the survey results we met with the clinical system provider to work together to coordinate an action plan to address issues identified. We are working through this action plan now to ensure patient safety is at the heart of how this system operates.

"We acknowledge all major software implementation projects require enormous change management, time and continued support so any and all risks are appropriately managed and mitigated. We have advertised for more senior positions to provide this increased level of support to our staff. Some of the issues raised in the survey have already been solved; others will be resolved by initiatives underway, including replacing our existing Patient Administration System. We would like to assure that the action plan to address the issues is being constantly monitored by the CEO and the Board of Directors."

Here is the link:

https://www.abc.net.au/news/2023-11-29/bendigo-health-internal-survey-staffing-issues-epr-records/103159344

Here is a link to the system page:

https://www.bendigohealth.org.au/ePR/

The system was provided by TrakCare who have seen all this many time before:

Here is a link to a press release.

https://www.hhmglobal.com/industry-updates/press-releases/bendigo-health-implementing-intersystems-trakcare-as-electronic-medical-record

What can I say other than that I have seen all of this zillions of time before and we can all be confident that in a year or so it will all have settled down and that most will be totally relaxed with using the new system.

There is always a struggle in the middle of this processes but at the end of the day the vast majority are a success!

All that is needed is for time to pass I reckon, and the edges to be smoothed.

David.

 

I Have A Strong Feeling Believing In The Promise Of AI As A Way To Get Value From The myHR May Be An Dangerous Illusion.

I don’t claim to be an expert but I can confidently assert that there are many, many spruikers for the advantages and possibilities of AI in the health sector.

This from the Harvard Business Review provides a flavour:

GenAI Could Transform How Health Care Works

by  Ron Adner and Dr. James N. Weinstein

November 27, 2023

Summary.   

Consider how Napster, the networked file sharing system, upended the music industry. The emergence of generative AI language models like ChatGPT, has much in common with this Napster-initiated inflection point: a breakthrough technology with breathtakingly fast adoption, appropriation of other people’s data (OPD), and predictions of doom and obsolescence. Similarly, the generative AI revolution that ChatGPT has catalyzed is not going to be reversed. Leaders should look to three touchstones to calibrate their strategies and prepare for the transition: First, distinguishing between the role of AI in driving technology substitution and its role in ecosystem transformation. Second, preparing for the new organizational design challenges that will arise because of this ecosystem transformation. And third, crafting strategies that take advantage of new asymmetries that arise from new combinations inside and outside your own organization.

------

The word “disruption” is usually associated with technology substitution that offers a better way of accomplishing a given task. But its more profound realization is in ecosystem transformation that rewires and resets the boundaries across the old silos. This distinction is crucial in confronting the impact of generative AI.

Consider Napster. The networked file sharing system upended the music industry. Before Napster, music companies wrangled for years over how to engage with the digitization of music. And then Napster took the decision out of their hands — it broke the logjam. Initially, music industry leaders sounded alarms about rampant theft of intellectual property. But ultimately music-as-data led to a new golden age of profits as individual songs were re-aggregated into personalized streams by new actors like Spotify and Apple Music. The model shifted from album sales to predictable monthly subscriptions. Today more music is heard, by more people, in more places, with more profit to the music companies than ever before. Ecosystem transformation unlocks value.

The present moment, so full of debate about the impact and implication of generative AI language models like ChatGPT, has much in common with this Napster-initiated inflection point: a breakthrough technology with breathtakingly fast adoption, appropriation of other people’s data (OPD), and predictions of doom and obsolescence. And while OpenAI and ChatGPT, like Napster, may themselves be eclipsed by subsequent organizations and platforms, the generative AI revolution that they have catalyzed is not going to be reversed.

(Where Napster’s enabling of the appropriation and distribution of other people’s music was core to its value, ChatGPT’s appropriation of other people’s data for training its large language models is now the subject of numerous lawsuits. We fully expect the question of intellectual property will loom large in AI’s future. Our focus here, however, will be not on the original training data but on the new and proprietary data to which these learning models will be applied.)

How will the advent of large language models and other new AI approaches reset your sector, and how should leaders prepare? Our discussion focuses on the impact of AI on the U.S. health care context, but our broad points apply to every complex ecosystem wrestling with this new stage of digital revolution. From our positions as a technology executive and former health system CEO (Weinstein) and a strategy researcher and advisor (Adner), we present these ideas in the hopes that leaders might conceptualize new ways of strategizing and interacting.

Three touchstones will help leaders calibrate their strategies and prepare for the transition: First, distinguishing between the role of AI in driving technology substitution and its role in ecosystem transformation. Second, preparing for the new organizational design challenges that will be required for this ecosystem transformation to deliver its value. And third, crafting strategies that take advantage of new asymmetries that arise from new combinations inside and outside your own organization.

Technology Substitution vs. Ecosystem Transformation

ChatGPT broke the record for technology adoption, gaining 100 million users in two months. Most discussions have focused on the question of what tasks it will improve and what jobs it will replace. In other words: technology substitution and how to respond to it. But it is disruption at the ecosystem level that transforms the game and raises the biggest opportunities for change. By combining and analyzing data across previously disconnected silos, generative AI creates the opportunity to raise the bar on efficiency and effectiveness across the spectrum of health care delivery. Consider just three examples:

Billing and Claims

Administrative expenditure accounts for 15–30% of health care spending in the U.S., of which about half is consumed by hospitals’ management of billing- and insurance-related expenses. And even these estimates are unfairly low as they ignore non-dollar indirect cost, borne by patients and their families — the time spent fighting for insurance coverage and clarification on billing. Allowing artificial intelligence to break the silos between insurers, hospitals, and consumers would automate claims management, prior authorization, and even payment planning and collections, helping to eliminate a massive drag on system efficiency.

Resource Management

Health systems are plagued by long cycles of oversupply (buffers held in case of emergencies) punctuated by sudden shortages (when emergencies turn out bigger than expected) of equipment, medicine, rooms, beds, and staff. Poor management of patient flow causes unnecessarily long hospital stays and delays in admissions for those who in serious need. Lack of coordination with extended care and rehabilitation facilities increases time spent at the most expensive place for care, and puts patients at increased risk for hospital acquired complications. AI will enable cross-platform coordination across hospitals, systems, partners, and vendors to create higher resilience and better patient placement, lowering risk, shorten recovery times while improving outcomes and lowering cost.

Redefining Quality

A positive outcome from an avoidable surgery? Accurate results from an unnecessary test? These contradictions highlight the need for quality and performance measures that consider the patient and the patient journey more holistically. By incorporating the latest advances in medical science and real-world evidence into treatment recommendations and measures, AI stands to improve patient outcomes and raise standards in ways that reduce burden on both the patients and the system.

As you set your vision for an AI-enabled future, consider the balance of aspiration between inside-the-box substitution and cross-silo transformation. How is this balance reflected in your investment priorities: capital expenditures, operating expenditures, and capability development?

Ecosystem Transformation Requires Organizational Transformation

Change is held back by an inability among the actors who succeed in the current system to find their way towards a new equilibrium. High cost on one income statement shows up as high revenue on another. These income statements, literal and figurative, are determined by organizational boundaries, routines, and records. The AI-enabled transformations in billing, resource management, and quality described above all hinge on sharing data in novel ways. This novelty, however, gives rise to a new set of emergent organizational challenges.

Changing data access changes authority

Historically, the decision hierarchy that guides the reporting structure in an organizations was matched by a parallel information hierarchy — incomplete views across silos that may lead to suboptimal decisions, but that allow for clear decision-making paths and more efficient execution. This is true inside organizations (e.g., nurses do not have access to HR records) and across organizations (e.g., hospitals don’t have access to insurers’ financial records). But the promised benefits of transformational AI rely on crossing these silos. This means that, beyond concerns of privacy and security, true transformation will require organizations to rethink the informational foundations of authority. Once released across data pools, AI eliminates organizational information censors. This is a huge ecosystem transformation, shifting the focus from insuring the accuracy of content (“Is the data correct?”) to controlling the breadth of questions (“Who is allowed to ask what?”). This shift from censoring data to censoring questions implies a radical change in fundamental principles administration and management.

New information demands new metrics

New visibility into new data combinations open debates on relevant and appropriate metrics which, in turn, impact goals and incentives. The core questions of what is the definition of success, and who gets to define it, moves to the forefront. Consider surgeon productivity in a world where data can be viewed across silos. Do you measure the number of procedures they manage in a month? The revenue they generate? What weights do you assign? In a world of merged data pools and open inquiry, anyone with access can create their own new measures, and the system needs to find a way of settling on a new equilibrium.

Transparency creates new responsibility

A corollary to visibility across data silos is the expectation of more holistic decisions that take the broader landscape into consideration. Historically, a doctor’s recommendation of the “best” treatment was based on optimizing medical outcomes. But with an AI-facilitated view of a patient’s broader circumstances outside of the medical visit – the specifics of their insurance coverage; their work situation; their homelife situation – the notion of “best” can change dramatically. How to incorporate economic and social lenses into a medical recommendation, and to do so in an ethically and legally defensible way, will become a critical new requirement for both providers and insurers.

As AI enables more visibility across silos what parts of your org chart and your governance need to be revisited. You must be proactive in making sure that the upside of giving more people more access to information is not overwhelmed by the unintended downside of new sources of conflict. For every organization in the ecosystem this will lead to a redefinition of rules and roles. For successful organizations, this will be handled with forethought, not as afterthought.

Lots more here:

https://hbr.org/2023/11/genai-could-transform-how-health-care-works

So, while we can see the added value in general the specifics of just how this way work clinically are a little hard to be sure of.

When you contemplate typical health data which is often disjointed, incomplete, full of abbreviations and hardly clearly formatted (or even legible) just how clear value is to be obtained can be a little less than obvious!

It is probably these attributes that provide the scope for an effective AI to add the most value and to obtain the most clarity, reliability, accuracy and utility!

Just having these attributes in records would surely improve patient safety and confidence in decision making!

What more arcane transformations of a record are fascinating possibilities as are the representational possibilities that might be engaged! A ‘meta’ record what adds value to the original is a fascinating possibility and clearly conceivable!

Clearly we can move well beyond just ‘tidying’ a record up – but how far might be useful I will leave to the reader’s imagination. However, I sure do not think the decrepit myHR is a place to start from!!!!

I am very interested in what others might add, and just what sort of record tool(s) might be ideal going forward!

David.

AusHealthIT Poll Number 725 – Results – 03 December, 2023.

Here are the results of the poll.

Is It Time To Give Up On The myHealthRecord?

Yes                                                                                36 (95%)

No                                                                                   2 (5%)

I Have no Idea                                                               0 (0%)

Total No. Of Votes: 38

A clear outcome with a huge majority feeling the time has come to drop it totally.

Any insights on the poll are welcome, as a comment, as usual!

A good number of votes. But also a very clear outcome! 

0 of 38 who answered the poll admitted to not being sure about the answer to the question!

Again, many, many thanks to all those very few who voted! 

David.

Even The College Is Worried About The Damage Possible By Uncrated Results!

This also on the topic of the week:

22 November 2023

Real-time diagnostics may prompt patient panic: RACGP

Diagnosis pathology Political RACGP

By Laura Woodrow

The college is worried that providing real-time results to patients on My Health Record will prompt a barrage of concerned calls to GPs and lead to misinterpretation.

---

While the RACGP supports pushing providers to upload pathology and diagnostic test results to My Health Record by default, it has stressed the importance of a seven-day delay to ensure patients aren’t going it alone.

In September, the Department of Health and Aged Care launched consultation on its plans to modernise My Health Record following recommendations made by the Strengthening Medicare Taskforce Report.

The federal government has since promised two years of funding dedicated to modernising My Health Record, including requiring providers to upload diagnostic imaging and pathology results to the platform.

“If a patient gets a diagnostic scan or pathology test, then those results should be uploaded. At the moment, this happens by exception. It is not the rule. I intend to make it the rule,” said Health Minister Mark Butler in May.

In its response to the consultation, the RACGP supported the proposal that would require providers to share pathology and diagnostic imaging by default.

But the college stressed that this shouldn’t replace communication between providers or a patient’s relationship their general practitioner.

As such, the college recommended that the seven-day delay rule – which dictates that pathology and diagnostic imaging results should only be available to patients after a week-long buffer period – should remain in place.

“Maintaining the seven-day rule allows consumers to have access to their health information, albeit with a small delay that allows their GP or other clinician to discuss their results with them,” said the college.

“We do not consider the benefit of real time access to results outweighs the potential harm of consumers misinterpreting results or receiving fortunate results with no immediate clinical support.”

According to a survey conducted by the AMA, 65% of patients agreed that they would want to speak to a clinician before receiving life changing results, noted the submission.

“While most patients will usually receive normal results, many will not, and receiving possibly life changing news via My Health Record with no support or context from the clinician who ordered the test is not appropriate,” read the submission.

The college raised concerns that real time access for consumers may cause distress and prompt patients to contact their GP to inquire about their results.

“Before viewing results, patients should see a message reminding them that their results need to be interpreted by a clinician and to not take action until they have spoken with clinician who requested the tests,” the college said.

“It should be emphasised that the clinician will be in contact with them, which is current standard practice for the follow up of test results.”

Results that are already available in real time such as influenza and HbA1c should be an exception to the seven-day rule, added the college.

If their advice isn’t heeded, the RACGP has called for a post-implementation evaluation into whether the change affected patient health outcomes.

The college added that a “thorough and wide-ranging communication campaign” was vital to ensure consumers are aware of the availability of their results on My Health Record and the burden is not on GPs to explain.

“GPs should not be expected to explain the changes to patients during consultations, so consumer resources available through practices (such as posters or flyers) that GPs can refer their patients to would be helpful,” the submission said.

The RACGP also noted that it was important for healthcare providers to be in the know well in advance of the rollout of any changes.

Beyond changes to availability of documents, the group said the “clunky, hard to navigate and slow” interface could do with a facelift.

The system will need to be responsive, efficient, consistent in terminology and have data input in a way that is easy to integrate into general practice clinical systems and allows large volumes of data to be sifted through with ease, added the college.

The consultation is now closed to submissions.

More here:

https://www.medicalrepublic.com.au/real-time-diagnostics-may-prompt-patient-panic-racgp/102960

It will be interesting to see what is finally done in this area! I think the College warning is a bit over the top!

David.

It Seems The Government Can’t Stop Fiddling With Its Near To Useless Toy! They Really Are Stubborn To Persist With It!

It looks like the Government has not thought its plans through again.

This appeared last week.

Should patients be able to immediately access results via MHR?

The DoH is looking to modernise My Health Record to include the default sharing of pathology and imaging reports, but the RACGP has concerns.

Matt Woodley

22 Nov 2023

The seven-day delay rule for uploading pathology and diagnostic imaging results to My Health Record (MHR) should remain in place, the RACGP has said.
 
The recommendation was included in a recent submission to the Department of Health and Aged Care (DoH), which is planning to ensure all pathology and diagnostic imaging providers share their reports to MHR by default by the end of 2024.
 
According to the DoH, this change has emerged out of the Strengthening Medicare Taskforce to ‘empower’ patients and make it easier for healthcare providers to coordinate care and make clinical decisions.
 
However, while the college supports default sharing as it could reduce duplicate testing, lowering both Medicare and patient out-of-pocket costs, it also indicated there are risks associated with making those results immediately available to patients.
 
‘Maintaining the seven-day rule allows consumers to have access to their health information, albeit with a small delay that allows their GP or other clinician to discuss their results with them,’ the submission states.
 
‘We do not consider the benefit of real-time access to results outweighs the potential harm of consumers misinterpreting results or receiving unfortunate results with no immediate clinical support.
 
‘If the seven-day rule is to be removed, the RACGP recommends evaluation is undertaken to provide data that this change to the My Health Record has achieved the goal of supporting better patient health outcomes.’
 
In addition to opposing the immediate sharing of pathology and diagnostic imaging results, the college has also said any updates to MHR need to be supported by a ‘thorough and wide-reaching’ communication campaign, targeted at both consumers and healthcare providers.
 
‘Communication with healthcare providers should begin well in advance of any changes coming into place,’ it states.
 
‘Peak primary healthcare organisations should be engaged to deliver information to their members to raise awareness of these changes, discuss potential impacts and provide direction on where to obtain assistance if required.
 
‘[Public] messaging should include information reinforcing the My Health Record is a consumer-controlled record and consumers are able to manage the privacy controls of their record to restrict access to specific healthcare organisations.
 
‘GPs should not be expected to explain the changes to patients during consultations, so consumer resources available through practices, such as posters or flyers that GPs can refer their patients to, would be helpful.’
 
The submission goes on to point out that practical barriers need to be overcome ahead of the changes being adopted.
 
‘Some RACGP members have described the My Health Record interface for viewing test results within their clinical information systems as “clunky, hard to navigate, and slow”,’ the RACGP said.
 
‘It has also been noted it is particularly difficult to see each result where multiple test reports are available and that it is difficult to access images.
 
‘Results will need to be sent to My Health Record as atomic data to support the seamless integration of reports into general practice clinical systems.’
 
Once the mandatory uploading of pathology and diagnostic imaging is in place, the college says general practice systems will need to: 

• efficiently search large volumes of data to ensure ease of access to relevant reports
• be responsive to ensure there are no system delays when displaying data
• display reports in a way that is easy to read and accessible
• provide consistency in terminology and reporting to support safe quality care.

More here:

https://www1.racgp.org.au/newsgp/professional/should-patients-be-able-to-immediately-access-resu

You can view the full RACGP response here:

Modernising My Health Record:

Sharing pathology and diagnostic imaging reports by default and removing consumer access delays’ consultation

Response by the Royal Australian College of General Practitioners

October 2023

https://www.racgp.org.au/getmedia/08c0d736-a8f7-4340-8595-cda98f0f9461/FINAL-RACGP-response-Modernising-My-Health-Record-consultation.pdf.aspx

The RACGP makes some good points but really avoids the elephant in the room by not suggesting that the myHealthRecord is a useless pile of crock and really should be put out of its misery.

It is important also to note that the myHR modernisation is still to happen as best I can tell but that when it does upload of all results needs to be clinically tailored for the patient.

Some routine results are fine ASAP and others need to be controlled by the ordering clinician IMVHO!

Readers here will be aware that the Government has been trying to enthuse clinicians regarding the myHR since 2012 as I recall and if it is not a raging success by now one wonders how long they will persist with it? After my experience discussed in the blog before this it is clear the myHR is dead!

I reckon the bureaucrats are plain misleading the Minister on most aspects of the myHR and that he needs to take a close look for himself and take serious advice on what to do! My experience of my record was a total bust! Time to give up on it…..

David.

The myHealth Record Is Decaying And Dying As We Watch. Neglect is Obvious. Time To Switch It Off!

With all the talk of myHR updating etc. I thought I would log on and have a peek at all the new stuff!

What I found was amazing. Those who browse here will know I have had some health excitement in the last year with months in hospital, tests galore and consultations to fill weeks of fun and records! Most of this was at least 3-4 months ago, so it should be in the record!

So how much has made it to my record?

Latest entry I could find was dated 2018!!!!

Here are some highlights:

Snapshot taken 26/11/2023

https://myrecord.ehealth.gov.au/portal/home

Welcome to My Health Record

This page shows the records you can view.

Recent documents timeline

No recent documents to view

There are no recent documents added to this My Health Record. Documents uploaded within the past 12 months will appear in this list. You can still add personal health information including:

Select the record you want to view

·         David G More

74 years

Information on Discharge Summaries

Event Date	Author	Organisation	Author Role	Access Level	Action
23-Feb-2018	Ramirez, M	North Shore Private Hospital	General Medical Practitioner	General	Manage Access
08-Feb-2018	Napthali, A	North Shore Private Hospital	General Medical Practitioner	General	Manage Access
22-Apr-2017	Chen, Andy	NSW Department of Health	Medical Practitioners nfd	General	Manage Access
03-Apr-2017	Srivastava, Tarini	NSW Department of Health	Medical Practitioners nfd	General	Manage Access
08-Aug-2016	Davidson, Briony	NSW Department of Health	Hospital Pharmacist	General	Manage Access

Pathology Reports

Pathology reports provide the outcome of pathology tests performed. If you wish to know more about your pathology test results and tests performed, please see Lab Tests Online.

Space was empty!

---- End Extracts

Not a thing from any of the hospitals or doctors at all – so I am all good apparently.

What a joke and obscene waste of money. Questions in Parliament are sure needed!

David.

I Am Amazed That This Truth Has Not Been More Remarked Upon Over The Ages!

This appeared a few days ago

NSW Customer Service says digital "cannot be the only answer"

By Kate Weber

Nov 23 2023 12:38PM

Inclusivity and social cohesion drive decision-making.

The NSW Department of Customer Service has warned against over reliance of digital solutions to solve community issues, highlighting the importance of inclusion in the digital government service delivery age.

Deputy secretary for customer delivery and transformation Sarah Cruickshank told a Digital NSW 2023 showcase event in Sydney yesterday that the department is considering how customer-focused plans “reflect the public policy priorities of the government”.  

She said digital solutions aren't the sole solution to building harmonious communities.

“Digital cannot be the only answer for how we deliver government services, support and programs,” Cruickshank said.

“Over reliance on digital, whilst it will cater for the majority of people, actually runs the risk of creating and entrenching even further isolation for those that are already not feeling as connected to society as they should."

Cruickshank said the focus of government is around “social cohesion”, adding that NSW DCS has specific targets to ensure “that Aboriginal and Torres Strait Islander people have the equivalent access to digital services and general digital inclusion as the rest of the population by 2026.”

During the talk, Cruickshank said that social cohesion was also impacted by macro factors - outside of the government's control - notably "international security".

“Unfortunately, international security is something that has become more and more a space that governments are occupied with, and are investing heavily in. This obviously has cybersecurity implications as well," she said.

“But just generally, geopolitical security is causing a lot of angst within communities”.

Cruickshank said social and economic wellbeing is another aspect, with governments less focused on constant growth but rather ensuring basic community needs are meet.

“Australia has been largely immune until very recently from challenges with social cohesion," she said.

“Unfortunately, in recent months we've seen some fracturing of what has normally been a very harmonious society in Australia.

“There are other countries around the world that are in a much more difficult situation than we are. But we need to do everything as governments to ensure that we maintain and strengthen the cohesion within our society.”

Customer metrics

Cruickshank said when the first State of the Customer report, which measures nearly 40 service lines across NSW government, landed earlier this year “we were obviously incredibly pleased with the results”.

The report revealed 77 percent of people found NSW services easy to access, 75 percent were satisfied and 73 percent trusted the government to deliver its services.

However, Cruickshank pointed out the pandemic “taught us a lot about how we need to engage better as government with communities.”

“That was the first time that government realised we had to get much better at how we communicated information to communities that were impacted, but also how we worked with those communities to help us in the way we supported those communities.”

Lots more here:

https://www.itnews.com.au/news/nsw-customer-service-says-digital-cannot-be-the-only-answer-602669

Talk about the blooming obvious and the stupidity of the so called thought-leaders! So often all you see is denial that the digitally incognoscenti actually exist!

It is inevitable that there will always be a good 5-10% of people who, for whatever reason, just can’t or won’t engage with the digital world!

Because this is true, we need to accommodate the outliers with tools and access to services they can use and feel comfortable doing so. Any system design which does not accept this realty just stores up trouble and complexity for itself! This is especially true when providing services we are all expected to access - like Health Service!

Just a good idea to return to reality every once in a while!

David.

AusHealthIT Poll Number 724 – Results – 26 November, 2023.

Here are the results of the poll.

Are We Doing Enough To Track Down And Punish Cyber-Fraudsters?

Yes                                                                                14 (34%)

No                                                                                 27 (66%)

I Have no Idea                                                               0 (0%)

Total No. Of Votes: 41

A clear outcome with a majority feeling it is possible to do more.

Any insights on the poll are welcome, as a comment, as usual!

A good number of votes. But also a very clear outcome! 

0 of 41 who answered the poll admitted to not being sure about the answer to the question!

Again, many, many thanks to all those very few who voted! 

David.